Wednesday, September 1, 2010

Do good intentions count? Do actions really speak louder than words?

"I really meant to call."

I was meaning to call, but got so busy."

I wanted to stop by, really, I did. But my kids are sick and I thought I would make her sick."

"I didn't know what to say."

These are all excuses I hear from well-meaning friends and relatives who call us to get information about a patient's medical status. I have probably used the same excuses myself.

We all get busy. We all mean to call or to write or to stop by or to buy that card. Many times we have very good intentions, we just don't always follow-up on them. And then time gets in the way and moves us too far forward and we think it is too late to go back now and call or write or whatever.

But it isn't. It is really never too late.

"I haven't heard from her in years," said a patient recently when I told her about a phone call we received from an old friend. "Why is she calling now I wonder?"

We didn't wonder. This was a woman who was well liked by many and we had received many calls. But we are not allowed to give any information to non-family members, so we always refer the questions to the patient or their family members or caregiver.

Her friend had said she knew about the patent's illness from others. They had been best friends in high school, but had lost touch since graduating some 40 odd years ago. They often kept in touch only by the occasional reunion or Christmas card.

"But I never forgot her," her friend said to me. "Life has a way of getting in the way of things that matter to us, keeping us apart. But I have loved her since the 9th grade. She was part of me. Will always be part of me. I never told her that. It seemed like my life going forward with my husband, my kids and my career became me. And that is true to some extent. But that alone did not shape me. You never forget the ones that helped to shape your life. And when they are going to be gone forever, it leaves a huge whole. Bigger than I ever could have imagined. I should have called or visited. I should have written a note. Is it too late now?"

The patient was on home hospice care, pretty much bed-ridden at this point in time. But she was still alert, still taking visitors, still answering the phone. Still alive.

"It is never too late for the living," I told the friend.

"But what if she is mad at me for being quiet all of this time. I really had good intentions. I did. Should I tell her that? Do good intentions count?"

I said I wasn't sure. Perhaps they could count if they are known. But once someone is gone, good intentions provide little comfort.

So she called. They lived 400 miles apart, so a face to face visit was probably not going to happen, but they talked each day for a few minutes and exchanged cards and pictures and their lives met up again.

"I often wondered about Jane," my patient said, her eyes smiling as she talked about her. "I could have called her too, you know. It is not just her fault. She told me about all of her intentions. I told her about all of mine. I am not sure what kept us from doing the things we wanted to do, but that is just water under the bridge now. Swept away. Her good intentions were voiced to me and mine to her and that is good enough. I never really paused enough to reflect on how much the people in my past younger life meant to me. We focus so much on the current, but the past is part of us as well. She will always be a part of me and I of her. Isn't that amazing. Isn't life a grand journey."

This patient died recently, but it made me stop to think about all the good intentions I have had over the years that I never got around to sharing. And I wondered if it was too late as well. But Clara, my patient, taught me something. That good intentions really do count.

That words can be just as powerful as actions.

As long as they are spoken and can be heard and shared.

In the End, we will remember not the words of our enemies, but the silence of our friends.
~~Martin Luther King, Jr

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